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Prevalence of pulmonary hypertension in patients with chronic kidney disease without dialysis: a meta-analysis

  • Nephrology - Original Paper
  • Published:
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Abstract

Purpose

Recent epidemiological evidence attempts to demonstrate the risk of pulmonary hypertension (PH) among patients with chronic kidney disease (CKD) without dialysis, but prevalence estimates of PH in CKD without dialysis vary widely in the existing studies. This meta-analysis was to summarize the point prevalence of PH in adults with CKD without dialysis.

Methods

PubMed, EMBASE, the Cochrane Collaboration, and the reference lists of relevant articles were searched to identify eligible studies. We used a random-effect meta-analysis model to estimate the prevalence of PH. Associations were tested in subgroups and meta-regression analyses. We also performed sensitivity analyses and assessments of publishing bias.

Results

Twenty-one observational studies (n = 8012 participants) were included in this meta-analysis. The result of analysis in random-effect model showed that the pooled prevalence was 32% (95% CI 23–42%), with significant heterogeneity between these studies (I2 = 98%, P < 0.01). Stratified analyses found that the study design, region, sample size, year of publication, and definition of PH based on PASP ≥ 35 mmHg may explain the variation between studies. Sensitivity analysis further demonstrated the results to be robust. There was no evidence of publication bias.

Conclusions

PH is highly prevalent in patients with CKD without dialysis. Owing to the high heterogeneity, future well-designed and large prospective studies are encouraged to confirm the findings and definitively clarify the potential biological mechanisms.

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Abbreviations

CKD:

Chronic kidney disease

PH:

Pulmonary hypertension

PASP:

Pulmonary artery systolic pressure

RHC:

Right heart catheterization

TRV:

Tricuspid regurgitant velocity

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Author information

Author notes

  1. Weifeng Shang and Yuanyuan Li have contributed equally to this work.

Authors and Affiliations

  1. Department of Nephrology and Rheumatology, The Forth Hospital of Wuhan Affiliated with Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, Hubei, People’s Republic of China

    Weifeng Shang, Wei Li, HongLan Wei & Junwu Dong

  2. Department of Respiratory Medicine, The Forth Hospital of Wuhan Affiliated with Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, Hubei, People’s Republic of China

    Yuanyuan Li

  3. Department of Medical Affaires, Liyuan Hospital Affiliated to Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, Hubei, People’s Republic of China

    Yali Ren

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  1. Weifeng Shang
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Contributions

JD and WS conceived and designed the study. WS, YR, and YL screened the abstract and full text, extracted the data, assessed the studies, and drafted the manuscript. WS, YL, WL, and HW performed the statistical analyses. WS, and JD revised the manuscript. All authors read the manuscript and approved the final version.

Corresponding author

Correspondence to Junwu Dong.

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The authors declare that they have no competing interests.

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This article does not contain any studies with human participants or animals performed by any of the authors.

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Shang, W., Li, Y., Ren, Y. et al. Prevalence of pulmonary hypertension in patients with chronic kidney disease without dialysis: a meta-analysis. Int Urol Nephrol 50, 1497–1504 (2018). https://doi.org/10.1007/s11255-018-1853-6

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  • DOI: https://doi.org/10.1007/s11255-018-1853-6

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